Fairmont Premier Insurance Company

What they litigate

Disputed issues across the decisions this insurance carrier is named in. Every row opens the decisions it counts.

• Jurisdiction / venue4
• Statute of limitations3
• AOE/COE2
• Permanent disability rating2
• Temporary disability2
• Medical treatment / UR / IMR1

Where they appear

• Santa Ana 4
• Anaheim 2
• Van Nuys 2

How the appealed decisions came out

These are decisions that were appealed and published — the tail of a system that mostly settles. Most claims end in a compromise and release or a stipulation and never reach a panel, so nothing below describes how this insurance carrier does its work. It describes how a set of appealed disputes came out.

• 5 for the applicant
• 2 for the defense

Counted over 7 appealed decisions. Not this insurance carrier’s book of work.

Decisions

Newest decisions this insurance carrier is named in, each with the passage the panel turned on and a link to the official PDF.

• ADJ8671084 · 2024-05-31 · Santa Ana District OfficeMedical treatment / UR / IMRdefendant prevailed

  Determinative passage · p.2Based on our review of the record and applicable law, we find merit in defendant's contention that the WCAB lacks jurisdiction over this dispute because its essence is the reasonable value of Dr. Nathan's services, not coding or the rectitude of defendant's EORs as suggested by the WCJ. We also conclude that it is appropriate to allow this matter to proceed to IBR. Accordingly, we will rescind the WCJ's decision and replace it with a decision reflecting the above conclusions.

  The WCAB found that the dispute was over the reasonable value of Dr. Nathan's services and thus subject to Independent Bill Review, not WCAB jurisdiction, rescinding the WCJ's decision.

  Official decision · page 2 →
• ADJ10110126 · 2024-05-16 · Santa Ana District OfficeStatute of limitationsdeferred

  Determinative passage · p.16as a professional athlete, Occupational Group No. 590, by the Atlanta Falcons, New Orleans Saints, Pittsburgh Steelers, the Los Angeles Rams, and the St. Louis Rams, claims to have sustained injury arising out of and in the course of employment to head, neck, shoulders, hands, wrists, fingers, elbows, back, hips, knees, ankles, feet, toes, neurological, internal, sleep, psyche, and chronic pain. 2. At the time of the claimed injury, the workers' compensation carriers for the various employers were: (1) Great Divide Insurance, administered by Berkley Entertainment for the Atlanta Falcons; (2) Louisiana Workers' Compensation Corporation for the New Orleans Saints; (3) State Workers Insurance Fund for the Pittsburgh Steelers; (4) California Insurance Guarantee Association for Legion Insurance, in liquidation for the Los Angeles Rams; (5) Fairmont by Zenith for the St. Louis Rams; and, (6) Travelers Insurance also for the St. Louis Rams. 3. The Workers' Compensation Appeals Board has subject matter jurisdiction over the claimed injury. 4. The conferral of jurisdiction arising out of applicant's California contract of hire precludes the enforcement of choice of law/forum selection clauses. 5. The issue of whether compensation is barred by Labor Code section 5405 is deferred.

  The issue of whether compensation is barred by section 5405 is deferred pending further proceedings.

  Official decision · page 16 →
• ADJ9146501 · 2023-02-06 · Santa Ana District OfficeJurisdiction / venuedefendant prevailed

  Determinative passage · p.5Here, applicant appears to have played four games in California during the course of his professional career, and also testified to participating in practices during a fifth trip to California, though he did not actually play in that game. Applicant does not appear to contest the WCJ's finding that he played in at least 146 games across his career, each with their own associated practices.3 Therefore, even viewing matters in the light most favorable to applicant, it appears that his total California exposure amounts to at best approximately 3% of his total playing career almost exactly the same percentage as in Johnson, where one game out of 34 also represented roughly 3% of the injury exposure the Johnson Court considered.

  The applicant's cumulative trauma injury exposure in California was only about 3% of his total career, insufficient to establish a significant connection to California for jurisdiction under Johnson, and the exercise of jurisdiction would violate due process.

  Official decision · page 5 →
• ADJ10232171 · 2022-03-25 · Van Nuys District OfficePermanent disability ratingdeferred

  Determinative passage · p.9Accordingly, we grant reconsideration, and we affirm the F&A including the rating of applicant's disability caused by factors other than that caused by the right knee and left knee injury; and we amend the F&A to defer the issue of the applicant's right and left knee disability; based thereon the issue of applicant's disability caused by the cumulative injury at issue herein is deferred; and the issue of attorney fees is deferred. We amend the Award and Order, and return the matter to the WCJ for further proceedings consistent with this opinion.

  The reports from orthopedic QMEs Dr. Einbund and Dr. Danzig were found not to be substantial evidence regarding the applicant's knee disability and apportionment, leading to deferral of the knee disability issue for further development.

  Official decision · page 9 →
• ADJ9990732 · 2021-03-09 · Van Nuys District OfficeJurisdiction / venueapplicant prevailed

  Determinative passage · p.9Accordingly, we will affirm the WCJ's finding of jurisdiction.

  Applicant was hired in California by the 49ers, which establishes sufficient connection for California jurisdiction over the claim; defendant failed to prove that exemptions under subdivisions (c) and (d) applied to applicant's last two employers; lack of personal jurisdiction does not exempt substantive workers' compensation law application.

  Official decision · page 9 →

Also recorded as

The same insurance carrier is printed several ways across the decisions, and all of them were counted as one. This is every spelling behind the figures above.

• Fairmont Premier Insurance Company
• FAIRMONT PREMIER INSURANCE COMPANY
• FAIRMONT INSURANCE
• Fairmont Premiere Insurance Company

Is this your company and something here is wrong? Tell us and we will fix it. Every figure on this page is a count of released decisions this insurance carrier is named in, and the decisions themselves are listed above with the passage each turned on.